WO2018055630A1 - Endoprothèse et procédé de pose d'endoprothèse - Google Patents

Endoprothèse et procédé de pose d'endoprothèse Download PDF

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Publication number
WO2018055630A1
WO2018055630A1 PCT/IL2017/051081 IL2017051081W WO2018055630A1 WO 2018055630 A1 WO2018055630 A1 WO 2018055630A1 IL 2017051081 W IL2017051081 W IL 2017051081W WO 2018055630 A1 WO2018055630 A1 WO 2018055630A1
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WO
WIPO (PCT)
Prior art keywords
stent
scaffold
symmetry
cells
inwardly
Prior art date
Application number
PCT/IL2017/051081
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English (en)
Inventor
Galit Avior
Tanhum Feld
Original Assignee
Galit Avior
Tanhum Feld
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Galit Avior, Tanhum Feld filed Critical Galit Avior
Priority to KR1020197011679A priority Critical patent/KR20190067185A/ko
Priority to AU2017331635A priority patent/AU2017331635A1/en
Priority to US16/336,742 priority patent/US20210220178A1/en
Priority to CN201780071888.XA priority patent/CN109963526B/zh
Priority to EP17852549.9A priority patent/EP3515361A4/fr
Priority to JP2019537426A priority patent/JP2019532788A/ja
Publication of WO2018055630A1 publication Critical patent/WO2018055630A1/fr
Priority to IL265615A priority patent/IL265615B/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F11/00—Methods or devices for treatment of the ears or hearing sense; Non-electric hearing aids; Methods or devices for enabling ear patients to achieve auditory perception through physiological senses other than hearing sense; Protective devices for the ears, carried on the body or in the hand
    • A61F11/20—Ear surgery
    • A61F11/202—Surgical middle-ear ventilation or drainage, e.g. permanent; Implants therefor
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/848—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents having means for fixation to the vessel wall, e.g. barbs
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    • A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
    • A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
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    • A61F2/02—Prostheses implantable into the body
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    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
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    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/047—Urethrae
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2002/9505—Instruments specially adapted for placement or removal of stents or stent-grafts having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument
    • A61F2002/9511—Instruments specially adapted for placement or removal of stents or stent-grafts having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument the retaining means being filaments or wires
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
    • A61F2250/0018—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in elasticity, stiffness or compressibility

Definitions

  • This disclosure concerns a stent, particularly useful for placement within the Eustachian tube as well as a stenting method for such placement.
  • ETD Eustachian tube
  • Chronic Eustachian tube dysfunction has been implicated in the pathogenesis of many otologic disorders and is thought to be a principal cause of a variety of otologic surgical failures.
  • Patients with chronic middle ear disease have often been shown to have a mechanical narrowing of the ET, usually at the isthmus (junction of the bony and cartilaginous portions). ET dysfunction has also been associated with functional disorders of the cartilaginous part.
  • the Eustachian tube is ordinarily closed in the resting position and dilates to the open position typically with swallowing, yawning, and with other voluntary or involuntary efforts. Tubal opening typically lasts less than one -half second. Closure of the Eustachian tube is maintained by a valve-like function of the opposing mucosal surfaces, submucosal tissue, fat, muscle, and cartilage. This natural valve measures approximately 5 mm in length and lies within the cartilaginous portion of the ET located about 10 mm distal into the tube from the nasopharyngeal orifice's posterior cushion or torus tubarius.
  • OME Otitis Media with Effusion
  • Persistent middle ear fluid from OME results in decreased mobility of the tympanic membrane and serves as a barrier to sound conduction.
  • OME may occur spontaneously because of poor Eustachian tube function or as a response following Acute Otitis Media. This may occur in infants and children ages 1-6 years due to anatomical difference and physiological changes of the Eustachian tube.
  • the tube At birth, the tube is horizontal and approx.. 17-18 mm long. It grows to be at an incline of approx. 45 degrees and reaches a length of approx.. 35 mm in adulthood. Due to its' relatively horizontal position in infants and young children and the relatively short length, these subjects are more likely to suffer from Eustachian tube dysfunction.
  • Tympanostomy tubes are recommended for initial surgery. Often, however, complications are encountered with such tubes. Early complications include: persistent otorrehea 10-26%, blockage of the tube 0-9%, early extrusion, and hearing loss. Late complications include: persistent perforation after tube extrusion 3%, scarring of the tympanic membrane, atrophic membrane 21-28%, granuloma 5-40%, Tympanosclerosis 40-65%, and cholesteatoma 1 %.
  • US 6,589,286 and WO 2009/001358 disclose stents for deployment in the ET ⁇ "ET stent(s) "). While the former discloses such stent in general, that specifically disclosed and illustrated in the drawings of WO 2009/001358 has a leaf valve that enhances ventilation and drainage to the middle ear as well as a stenting method for inserting the stent in the ET.
  • stent stent deployment assembly (comprising a stent, a stent delivery system and optionally an sent removal device) and a stenting method.
  • the stent of this disclosure has a unique design that renders it suitable, although not exclusively, for deployment in the Eustachian tube (ET) and assist the natural opening of the ET without hindering the natural closing operation.
  • ET Eustachian tube
  • a stent that embodies the characterizing features of this disclosure may be adapted to supplement and assist the natural opening operation of other variable body passageway, without hindering the natural closing operation.
  • a stent of this disclosure may also, for example, be configured for deployment in the bile duct for the treatment of Sphincter of Oddi Dysfunction (SOD), in which the sphincter can malfunction, not letting the digestive juices through as it should; or configured for deployment in the esophagus for the treatment of lower or upper esophagus sphincter dysfunction; or configured for deployment in the urethra for the treatment of urethra sphincter dysfunction.
  • SOD Oddi Dysfunction
  • the stent of this disclosure is a collapsible stent which functions to open a blocked or clogged lumen and, at the same time, is adapted to permit the natural closing and opening of the lumen.
  • an ET stent is configured to support the walls of the ET to thereby facilitates drainage of fluids from the middle ear to the nasopharynx cavity and pressure equalization in the middle ear, while permitting closure of the natural valve of the ET.
  • the stent has a scaffold formed by struts that are shaped so as to form cells within the scaffold, which may be open or closed cells or a combination of the two.
  • the properties of the struts e.g. width, thickness, etc.
  • cells' properties e.g. size, whether the cells are open or closed cells or the relative proportion of open and closed cells
  • the scaffold is typically designed to have an oversize (namely the cross-sectional dimensions that the stent expands to if unhindered is larger than the cross-sectional dimensions of the lumen in which it is deployed) and the extent of the oversize may also be important in controlling the scaffold's flexibility or rigidity.
  • this function of opening a variable passageway such as the ET, on the one hand, and permitting natural closure on the other hand can best be achieved by a stent which is not axial-symmetric but rather has a longitudinal plane of symmetry with two sides of the stent that are mirror images of one another.
  • the ET portion proximal to the nasopharynx cavity acts as a natural valve in that its walls can collapse to thereby close this passageway; and opened, through the contraction of surrounding smooth muscle, by moving away from one another. Opening occurs, for example, in response to actions of swallowing or yawning.
  • the contraction in many sphincters in a tubular passageway is not in an axial symmetric manner, but rather achieved through a concerted displacement of two opposite walls portions towards one another.
  • the stent of this disclosure is, particularly, useful for deployment in tubular passageways in the body that have a sphincter, which operates to close and open the passageways in an axial non-symmetric manner.
  • a Particular embodiment of a stent of this disclosure is, thus, a stent embodying the above features and having a longitudinal plane of symmetry (a plane defined and extending along the stent's axis), rather than an axial one.
  • the stent has a peripheral scaffold that is intrinsically biased into an expanded state, which is a state in which the scaffold extends to its maximum extent. In this expanded state, the stent has a length defined between a proximal and a distal end of the scaffold.
  • the stent's scaffold as noted above, has a longitudinal plane of symmetry that extends lengthwise along the stent, between the two ends. In other words, the stent's scaffold, although not being axial-symmetric, has two side that are mirror images of one another.
  • an inwardly directed force on the mirror-image sides, in a direction normal to the plane of symmetry, causes an inwardly directed displacement that is larger than that caused by the same inwardly directed force applied, however, in a direction parallel to said plane of symmetry.
  • this stent reacts differentially to a radial force in different directions, exerting a weaker displacement resistance to a force applied in a direction normal to said longitudinal plane of symmetry as compared to that of a force applied in a direction normal thereto.
  • the term “axial” is used to denote a general orientation defined by the stent's axis (extending between its two ends), although it is understood that once deployed, the stent may not be entirely straight and accordingly the axis may be curved; the term “vertical” is used to denote a direction is be used to denote a direction normal to the axis and normal to said plane of symmetry. Further, the terms “proximal” and “distal” are used in relation to the direction in which it is inserted and deployed; for example, in the case of an ET stent, the proximal end or segment is that closest to the nasopharynx cavity. The terms “lumen” or “passageway” are used to denote such structures within the body.
  • the ET stent In use, the ET stent is deployed such that its lateral scaffold portions come to bear on the lateral wall portions of the ET.
  • the lateral portions of the scaffold are configured to have elastic properties such that they expand with the lateral wall during the walls expansion and opening and provide also relatively small resistance that would not hinder the walls' collapse to seal the passageway.
  • the ET stent adds support to opening, it does not function cause the passageway to remain constantly open and, hence, facilitates natural valve function.
  • the stent of this disclosure is typically axial non-symmetric.
  • the overall cross-section of the stent primarily in the proximal segment is non-circular and may, for example, be oval or elliptic.
  • the ET stent may be configured for deployment in only the proximal portion of the ET; or it may be configured for deployment in only in the cartilaginous part of the ET and may be seated along the cartilaginous part or only a portion thereof part of it; or it may be configured to be seated along the natural valve or escape it; or it may be configured for deployment to fill a larger portion of the length of the ET.
  • the stent may have a relatively uniform cross-sectional shape and dimension along its axis, in other embodiments the stent may have different cross-sections to fit different portions of the passageway; for example, in the case of an ET stent, proximal sections of the scaffold may be larger than distal ones.
  • a stent of this aspect may be designed to have different dimensions depending on its target population: for example, small stents used for infants, toddlers or young children and larger ones for older children or adults.
  • the ET stent has a scaffold that comprises an array of cells.
  • the cells may be closed cells, open cells, or a combination of the two.
  • the structural features of the cells influence the flexibility and displacement resistant properties of the scaffold. These include, for example, the relative proportion of open and closed cells, the overall size and configuration of cells, as well as the physical properties of the struts.
  • the relative proportion of open and closed cells may be different in different parts of the scaffold, imparting different physical properties (including flexibility and displacement resistance) to different portions of the scaffold. This may also be achieved by having cells of different sizes in different portions (larger cells generally causing the scaffold to be with increased flexibility and lower displacement resistance than portions with small cells). Larger cells or a high proportion of open cells may typically be at lateral portions of the scaffold.
  • the stent's scaffold is formed by generally zig-zagging, Z- shaped or sinusoidal-like struts that extend between the two opposite ends of the scaffold.
  • the struts form oppositely oriented apexes. Consecutive apexes with the same orientation are separated from one another by an apex distance, referred to herein as apex distance; and consecutive opposite apexes are separated from one another by lateral distances, defined between the line tangential to the apexes, which will be referred to herein as amplitude length.
  • opposite apexes of adjacent struts are circumferentially connected to form closed cells or some may not be connected to thereby form open cells.
  • Different flexibility and displacement resistance of different portions of the stent may be achieved through variations in the properties and configurations of the struts which may be one or more of (i) variations in the apex distance; (ii) variations in the amplitude length; and (iii) variations in the struts in at least one portion of the scaffold as compared to at least one other portion.
  • the stent has a scaffold which is constituted by two mirror-symmetric parts linked to one another only at the ends of the stent.
  • This stent will be referred to below as a "mirror-symmetric stent".
  • the two parts of the mirror-symmetric stent may be articulated to one another at their two ends, they are typically integrally formed.
  • the scaffold of the mirror-symmetric is also intrinsically biased into an expanded state that has said longitudinal plane of symmetry that extends between its two ends.
  • the two mirror-imaged parts of the scaffold of the mirror-symmetric stent are typically linked to one another only at their ends.
  • the scaffold of the mirror-symmetric stent has, typically, an overall non- circular cross-section with the two opposite mirror image parts usually defining an opposite generally vertical and, at times, outwardly-curved planes.
  • the mirror-symmetric stent may comprise two or more struts extending between the two ends, being linked to an integral with the mirror image struts in the opposite part of the scaffold.
  • the struts may be linked to one another by lateral elements, e.g. lateral bars spanning the width between the struts.
  • the struts may also, by some embodiments, have an overall configuration similar to the struts described above with a generally sinusoidal zig-zagging or Z- shaped configuration, forming open or closed cells.
  • the stent is typically configured such that the scaffold is in its expanded state has an oversize of at least one portion of the scaffold than the corresponding portion of the lumen in which it is to be deployed.
  • This oversize means that the stent would naturally expand to dimensions slightly larger than those of the lumen's corresponding portion.
  • Such oversize causes the stent to apply constant force on the walls of the passageway and this fact, as well as oversize variations between different axial locations may aid in fixing the stent in position and avoid migration.
  • the ET stent may comprise elements intended to aid in the stent removal. These elements may, for example, be integrally formed with the scaffold or may be non-integral elements linked or tied in some manner to the scaffold. Examples of such elements are a tailing arm formed by the joint ends of the struts of the scaffold that are braided together, may be a thread, cable, wire, suture or tab, at the proximal end.
  • an arm, cable or tab attached to the proximal end of an ET stent may extend and protrude from the orifice of the ET into the Nasopharynx space.
  • the arm, cable or tab may cross through the natural valve at the orifice of the ET and may engage with an anatomical feature, e.g. a muscle, that moves when swallowing. On such engagement, the arm, cable or tab will be pushed and apply pressure on the natural valve. The natural valve will be forced open and allow the ET to ventilate.
  • the stent comprises anchoring elements integrally formed with the scaffold having the purpose of holding the stent in place to avoid its migration.
  • the stent of this disclosure may be made of a variety of materials, such as Nitinol, stainless steel, cobalt chromium, a variety of other metals, silicon rubber, a variety of polymeric materials particularly biodegradable or bio-absorbable materials such as poly-lactide base materials.
  • the scaffold may be made of one material and coated by another, such as, for example, made from Nitinol struts that are coated by a polymeric material.
  • the stents of this disclosure may also be configured, by some embodiments, to elute drugs to their surrounding tissue.
  • Drugs that may be included in such drug-eluting stents include, for example, steroids, anti-inflammatory drugs, antibiotics, etc. Techniques for incorporating drugs onto drugs are generally known.
  • the stents may be made by a variety of manufacturing techniques, such as laser cutting, braiding, 3D-printing, injection molding, compression molding, etc.
  • the stent may be configured
  • a delivery system for deployment of the stent such delivery system may include a delivery catheter, which in the case of an ET stent is inserted through the nasal orifice, preferably using a scope guidance.
  • the delivery system may be based on such commonly used for delivering self-expanding stents and may include an outer sheath for compressing the stent to a small diameter and an inner sheath over which the stent is compressed.
  • the delivery system may also comprise a guide wire that guides the advance of the inner sheath. Once in position the outer sheath may then be pulled back to expose the stent and allow it to deploy; and following deployment, the inner sheath may also be retracted.
  • the catheter's manipulating end may be provide with markings to aid in safe deployment of the stent.
  • the stenting procedure of this disclosure may be preceded by a balloon expansion of the passageway, similar to that performed in angioplasty, intended to apply radial compression on the walls, expand the opening and squeeze out fluid and mucus.
  • a balloon expansion of the passageway similar to that performed in angioplasty, intended to apply radial compression on the walls, expand the opening and squeeze out fluid and mucus.
  • site preparation may make the stenting procedure easier and allow the stent to fully deploy inside the passageway to achieve full engagement with the surrounding tissue.
  • Fig. 1 is a schematic representation of a stent of an embodiment of this disclosure deployed in the ET.
  • Figs. 2A and 2B are views from the direction of arrow II in Fig. 1 in respective open and closed state of the ET.
  • Fig. 3 shows a stent of an embodiment of this disclosure having different dimensions in different portions along its length to fit corresponding portions of the ET and being configured such that its proximal end will jut out of the ET to permit stent removal.
  • Fig. 4 shows a stent configured for deployment in a specific portion of the ET, typically within the cartilaginous portion distal from the natural valve.
  • Fig. 5 shows a stent of this disclosure provided with a braided tail end.
  • Fig. 6 is a schematic representation of a stent with an annexed leg that extends into the nasopharynx cavity.
  • Fig. 7 is a schematic representation of an embodiment of mirror-symmetric stent.
  • Fig. 1 showing a stent 100 according to an embodiment of this disclosure, deployed within the ET.
  • Stent 100 has a peripheral scaffold 102 formed by a plurality of struts 104 that follow a generally sinusoidal path extending between the proximal end 106 and the distal end 108 of the stent. Opposite apexes, in adjacent struts of this sinusoidal structure, are connected to one another at connection points 110 to thereby define a plurality of closed cells 112.
  • the stent has an overall elliptical or oval cross-section defining a longitudinal plane of symmetry represented by dashed line 120, separating between the two sides that are mirror images of one another.
  • the stent is thus configured such that an inwardly directed force in the direction normal to plane 120, as represented by arrow 122, would cause larger displacement than a similar force applied in a vertical inward direction, represented by arrow 124.
  • Figs. 3-5 illustrate different stent configurations.
  • stent 130 has segments with different cross-sectional dimensions including a distal segment 132 with a narrow dimension; and a proximal segment 134 with a wider dimension.
  • the cells in segment 134 are larger and hence with larger apex distance and/or amplitude length and accordingly the rigidity and displacement resistance is overall lower than in the distal segment 132.
  • Fig. 4 illustrates a stent 138 configured for deployment in only a portion of the ET and Fig. 5 illustrates a stent 140 which has a tail end 142 constituted by the braided ends of the struts.
  • Fig. 6 illustrates a stent 146 with an arm 148 annexed to the proximal end 150 of the scaffold.
  • the stent is deployed in an cartilaginous portion of the ET distal from the natural valve at the ET's proximal end and the arm 148, thus, crosses through the natural valve to engage with an anatomical feature, e.g. a muscle, that moves when swallowing.
  • an anatomical feature e.g. a muscle
  • the arm 148 be pushed and apply pressure on the natural valve.
  • the natural valve will be forced open and allow the ET to ventilate.
  • Fig. 7 illustrates a mirror-symmetric stent 160 that comprises two mirror- symmetric parts 162A and 162B extending lengthwise between the proximal and distal ends and comprising respective struts couples 164A, 165A and 164B, 165B, each integrated with its mirror image strut at integration points 170 and 172.
  • the struts couples are linked to one another, by a pair of lateral bars 166A, 167A and 166B, 167B.
  • Each of parts 162A and 162B form a generally vertical slightly outwardly-curved plane. This structure provides for flexibility of the scaffold only in the lateral direction about the terminal points of integration 170 and 172 and permitting very little, if any, inwardly-directed vertical displacement.
  • the above stents are deployed such that the stents vertical portions juxtapose the lateral portions of the passageway and, consequently, permit a degree of lateral inward displacement of the walls of the.
  • the stent of this disclosure may be anchored by forces resulting from variations in radial force, cross-section and/or its eccentricity along its longitudinal axis.
  • the stent of this disclosure may also include means to hold the stent in place and avoid migration.
  • Such means may comprise bars or other projections that protrude from the stent cylindrical envelope and anchor the stent in place.
  • bars or other projections may be formed at multiple locations along the stent length.
  • zigzag pieces of the laser cut stent may be set to protrude from the stent cylindrical envelope ("fish scaling") and help resist migration.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Veterinary Medicine (AREA)
  • General Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Public Health (AREA)
  • Animal Behavior & Ethology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Cardiology (AREA)
  • Transplantation (AREA)
  • Otolaryngology (AREA)
  • Physics & Mathematics (AREA)
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  • Acoustics & Sound (AREA)
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Abstract

L'invention concerne une endoprothèse destinée à être déployée dans la trompe d'eustache et d'autres voies corporelles qui supportent les parois et aident à l'ouverture naturelle du voie sans gêner l'opération de fermeture naturelle.
PCT/IL2017/051081 2016-09-26 2017-09-26 Endoprothèse et procédé de pose d'endoprothèse WO2018055630A1 (fr)

Priority Applications (7)

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KR1020197011679A KR20190067185A (ko) 2016-09-26 2017-09-26 스텐트 및 스텐팅 방법
AU2017331635A AU2017331635A1 (en) 2016-09-26 2017-09-26 Stent and stenting method
US16/336,742 US20210220178A1 (en) 2016-09-26 2017-09-26 Stent and stenting method
CN201780071888.XA CN109963526B (zh) 2016-09-26 2017-09-26 支架和支架植入方法
EP17852549.9A EP3515361A4 (fr) 2016-09-26 2017-09-26 Endoprothèse et procédé de pose d'endoprothèse
JP2019537426A JP2019532788A (ja) 2016-09-26 2017-09-26 ステント及びステント挿入方法
IL265615A IL265615B (en) 2016-09-26 2019-03-26 Stent and stenting method

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US201662399674P 2016-09-26 2016-09-26
US62/399,674 2016-09-26

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CN112402078B (zh) * 2020-11-05 2021-08-17 苏州法兰克曼医疗器械有限公司 一种防位移呼吸道支架
CN115192250A (zh) * 2022-06-28 2022-10-18 柏为（武汉）医疗科技股份有限公司 咽鼓管支架组件及其应用方法

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IL265615B (en) 2022-03-01
CN109963526B (zh) 2022-04-12
US20210220178A1 (en) 2021-07-22
CN109963526A (zh) 2019-07-02
JP2019532788A (ja) 2019-11-14
EP3515361A4 (fr) 2020-04-29
AU2017331635A1 (en) 2019-04-18
KR20190067185A (ko) 2019-06-14
IL265615A (en) 2019-05-30
EP3515361A1 (fr) 2019-07-31

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